| Illuminated Wellness | |
|
512 W Maywood Ave Peoria IL 61604-2838 | |
| (319) 504-5698 | |
| Not Available |
| Full Name | Illuminated Wellness |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 512 W Maywood Ave, Peoria, Illinois |
| Authorized Official Name and Position | Jennifer Zeck (OWNER) |
| Authorized Official Contact | 3195045698 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Illuminated Wellness 512 W Maywood Ave Peoria IL 61604-2838 Ph: (319) 504-5698 | Illuminated Wellness 512 W Maywood Ave Peoria IL 61604-2838 Ph: (319) 504-5698 |
| NPI Number | 1639881642 |
|---|---|
| Provider Enumeration Date | 12/21/2022 |
| Last Update Date | 12/21/2022 |
| Certification Date | 12/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639881642 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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